<div id="bentrai">
  <div id="main-content">
    <div id="deal-buy" class="box">
      <div class="box-top"></div>
      <div class="box-content">
        <div class="head">
          <h2>Điền đầy đủ thông tin đặt hàng
          </h2>
        </div>
        <div class="contactus">
          <div class="frmContact">
            <form action="/gio-hang/dat-hang.html" method="post" name="frmContact" id="frmContact" onsubmit="return validate_order();">
              <p>
                <label for="txtName"> Tên: <span>*</span></label>
                <input type="text" value="" id="txtName" name="txtName"/>
              </p>
              <p>&nbsp;</p>
              <p>
                <label for="txtPhone">Điện thoại: <span>*</span></label>
                <input type="text" value="" id="txtPhone" name="txtPhone"/>
              </p>
              <p>&nbsp;</p>
              <p>
                <label for="txtAddress">Địa chỉ: <span>*</span></label>
                <input type="text" value="" id="txtAddress" name="txtAddress"/>
              </p>
              <p>&nbsp;</p>
              <p>
                <label for="txtEmail">Email: <span>*</span></label>
                <input type="text" value="" id="txtEmail" name="txtEmail"/>
              </p>
              <p>&nbsp;</p>
              <p>
                <label for="txtContent">Nội dung: <span>*</span></label>
                <textarea id="txtContent" name="txtContent"></textarea>
              </p>
              <p class="note">Các thông tin có dấu <span>(*)</span> là yêu cầu cần thiết</p>
              <p class="btn">
                <input type="image" name="btnGui" id="btnGui" src="/img/btn_gui.png"/>
                <input type="image" name="btnXoa" class="reset" id="btnXoa" src="/img/btn_xoa.png"/>
              </p>
            </form>
          </div>
        </div>
      </div>
    </div>
    <div class="box-bottom"></div>
  </div>
</div>
